Surgical instrument for total hysterectomy.



W. L. BELL.

SURGICAL INSTRUMENT FOR TOTAL HYSTERECTOMY.

APPLICATION FILED JUNE I4, 1917.

Patented E61). 4, 1919.

y L'VI'I'NESS:

WILLIAM L. BELL, OF SANTA CRUZ, CALIFORNIA.

SURGICAL INSTRUMENT FOR TOTAL HYSTER'ECTOMY.

Specification of Letters Patent.

Patented Feb. 4, 1919.

Application filed June 14, 1917. Serial No. 174,714.

To all whom it may concern:

Be it known that I, \VILLIAM L. BELL, a citizen of the United States, and a resident of the city and county of Santa Cruz, State of California, has made a new and useful inventionto-wit. Surgical Instruments for Total Hysterectomy; and I do hereby deobjects as ,will appear as this description progresses.

In this specification and the annexed drawings the invention is illustrated in the form considered to be the best, but it is to be understood that the invention is not limited to such form, because it may be embodied in other forms and it is also to be understood that in and by the claims following the description it is desired to cover the invention in whatever form it may be embodied.

In the accompanying one sheet of drawings:

Figure 1 is a side elevation of an instrument constructed in accordance with this invention, partially broken away to disclose underlying structures.

Fig. 2 is a side elevation of the detached tubular cutting-blade.

Fig. 3 is fragmentary detail of a modified sheath end.

In detail the structure illustrated in the drawings includes:

A tubular sheath 1 having a rounded and polished upper edge 2. This sheath is provided with the annular shoulder or bead 3 spaced backward from the edge 2. An annular groove may be substituted for the bead 3. This sheath incloses the tubular blade 4: fitting snugly therein, the loWer edge 5 of the sheath being chamfered to facilitate assembling the blade 4 within the sheath. The blade is provided with a threaded opening 6 registering with an unthreaded opening in the sheath 1, to receive the set-screw 7 provided with a knurled head 8 to clamp the blade in fixed relation to the sheath. The cutting edge 9 of the blade, when fixed within the sheath by the set-screw, is spaced backward a distance from the edge 2 of the sheath. The opposite end 10 of the blade projects a convenient length beyond the end 5 of the sheath, to provide a hand-grip for manipulating the blade. lVlieii the instru ment is to be used in severing the uterus, the set-screw 8 is removed and the blade 1 rotatively advanced until the cutting edge9 extends beyond the edge 2 of the sheath, limited by the abutment of the stud 12 against the end 5 of the sheath. To facilitate bringing the opening 6 into registry with the set-screw 8 the blade 4-. is marked with an index as at 13 registering with a notch in the end 5 of the sheath in alinement with the screw 8.

This instrument is operated substantially as follows:

The patient is prepared in the routine nianner and placed in proper position on the operating table.

First: Proper size sheath 1 is chosen and inserted into the vagina preceding incision. The sheath must be the proper size to receive the cervix within the end and should be well lubricated and inserted gently until the cervix is encountered.

Second: The incision is made, the walls retracted and bleeding points ligated. The uterus is then supported by the hand of the operator while the tube is gently pressed upward. The cervix is now placed in the end of the tube if it is not already there. The uterus is now forced upward by the assistant. through the agency of the sheath 1 previously inserted, a heavy ligature is passed around the vagina near the bead 3, but far enough away from the end 2 of the tube to leave of an inch of tissue. A long clamp is now placed on each broad ligament, reaching down as far as the sheath 1. To insure against the displacement of said ligature the head of the sheath may be tapered toward the head 3 as illustrated in Fig. 3. It is now clear that all blood supply to the uterus is completely interrupted. The sheath 1, with the blade 4 inserted is brought upward until the vagina is encountered meantime the uterus being steadied from above by the hand of the operator. The blade 4 is now rotated from without, until the vagina is accurately incised annularly 'at the cervix. Following the removal of the uterus in this manner it is evident that the vagina at the top of the stump remains dry, visible and accessible and is held in place and visible by the sheath 1. The remaining steps are routine surgery and it is deemed superfluous to describe the further details here.

Having thus described this invention What I claim and desire to secure by Letters Patent is:

1. A surgical instrument including a tubular sheath; an annular ligature guide on said sheath; a tubular cutting blade slidable in said sheath having the cutting edge projectable beyond one end of said sheath in operative position and the handle end of said cutting blade always beyond the other end of said sheath; means for retaining said blade in said sheath and means for limiting the projection of'the cutting edge of said blade.

2. A surgical instrument including a tu bular sheath having an annular li ature guide thereon; and a tubular blade slidable in said sheath havingthe cutting edge projectable beyond one end of said sheath in operative position and the'handle end of said. cutting blade always beyond the other end of said sheath.

3. A surgical instrument including a tu bular sheathhaving a ligature guide thereon; a tubular blade the external diameter of which is less than the internal diameter of the sheath slidable in said sheath having the cutting edgeprojectable beyond one end of said sheath in operative position and the handle end of said cutting blade always bc yond the other end of said sheath; and

means for fixing said blade in said sheath.

In testimony whereof, I have hereunto set my hand at San Francisco, California,.tl1is 4th day of June, 1917 WILLIAM L. BELL. I

In presence of BALDWIN VALE, A. J. HENRY.

Copies of this patent may be obtainedfor five cents each, by addressing the Commissioner ofifiatentsg;

7 Washington, D; 23." 

